Application of Laparoscopy in The Diagnosis and Treatment of Acute Abdomen_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIHan-tuo , RENZhi-gang , LIMing-hui , CHENJing-hua , WUXiao-feng , FEIKe-ping

Department of General Surgery, Changping District Hospital in Beijing, Beijing 102200, China;

Corresponding author：

LIHan-tuo, Email: lihantuo@sina.com

Keywords：

Laparoscopy; Acute abdomen; Diagnosis; Treatment

DOI：

10.7507/1007-9424.20150089

Video：

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Objective To investigate the feasibility of laparoscopy in the diagnosis and treatment of acute abdomen. Methods The clinical data of 81 patients with acute abdomen treated in our hospital from January 2012 to December 2013 were retrospectively analyzed. Results Of the 81 patients with acute abdomen, there were 38 cases of acute appendicitis, 15 cases of gastric perforation, 10 cases of duodenal ulcer perforation, 10 cases of acute cholecystitis, 1 case of mesenteric artery embolism, 2 cases of internal hernias, 2 cases of ileocecal tumor, 2 cases of sigmoid colon rupture, 1 case of intestinal adhesion. The 81 cases were treated by laparoscopy, including 79 cases (97.5%) were clearly diagnosed; 73 cases were succeeded by laparoscopy, and 8 cases converted to laparotomy. The operation time were 35-191 minutes, with an average of 76 minutes; the intraoperative blood loss were 20-130 mL, with an average of 43 mL; the postoperative hospital stay were 3-13 days, with an average of 5.6 days. Seventy-six patients received followed-up for 2-24 months, and the median time were 14 months, no special complications occurred during follow-up period, but 1 case of ileocecal tumor suffered from lung metastases in 12 months after operation. Conclusions Laparoscopy can be used in the preferred way of diagnosis and treatment of acute abdomen.

Citation： LIHan-tuo, RENZhi-gang, LIMing-hui, CHENJing-hua, WUXiao-feng, FEIKe-ping. Application of Laparoscopy in The Diagnosis and Treatment of Acute Abdomen. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(3): 335-338. doi: 10.7507/1007-9424.20150089 Copy

1.	Richardson WS, Stefanidis D, Chang L, et al. The role of diagnostic laparoscopy for acute abdominal conditions:an evidence-based review. Surg Endosc, 2009, 23(9):2073-2077.
2.	马云涛, 苏河, 王斌, 等. 腹腔镜技术在外科急腹症中的应用. 中国微创外科杂志, 2009, 15(7):599-602.
3.	Hori Y; SAGES Guidelines Committee. Diagnostic laparoscopy guidelines:this guideline was prepared by the SAGES Guidelines Committee and reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), November 2007. Surg Endosc, 2008, 22(5):1353-1383.
4.	石美鑫. 实用外科学. 北京:人民卫生出版社, 2002:755, 921.
5.	杨昌毅, 陈志山, 洪黎清, 等. 腹腔镜技术在急腹症诊治中的应用. 中国实用医刊, 2014, 41(20): 40-41.
6.	戢运俊, 孙卫兵, 和梅亮, 等. 腹腔镜技术在急腹症1 035例诊治中的应用. 中国临床新医学, 2013, 6(7): 689-691.
7.	叶春. 腹腔镜阑尾切除术40例治疗体会. 中国普外基础与临床杂志, 2012, 19(5):521.
8.	刘长昆, 王建, 于世良, 等. 腹腔镜与开腹手术治疗老年急性阑尾炎患者的疗效对比分析. 中国普外基础与临床杂志, 2011, 18(7):766-768.
9.	胡斌, 邓剑, 赵叶平, 等. 腹腔镜技术在急腹症诊治中的应用体会. 中国普外基础与临床杂志, 2013, 20(1): 85-87.
10.	翟文裕. 腹腔镜技术在急性弥漫性腹膜炎治疗过程中的疗效观察. 新疆医学, 2013, 43(3):109-110.
11.	宋贤超. 腹腔镜在普外科急腹症治疗中的应用分析. 中国医药指南, 2012, 10(14):100-101.
12.	亓玉忠, 王国斌. 腹腔镜阑尾切除术700例分析. 腹腔镜外科杂志, 2008, 13(5):416-417.
13.	李伯琴. 腹腔镜上消化道溃疡穿孔修补手术护理配合. 现代医药卫生, 2009, 25(16):2528-2529.
14.	余育晖, 钱章选, 郭庆渠. 腹腔镜技术在非创伤性外科急腹症中治疗的体会. 浙江创伤外科, 2013, 18(5):686-687.
15.	马雪平, 赵国发, 崔猛胜. 老年人腹腔镜胆囊切除术创伤反应临床观察. 中华消化内镜杂志, 2003, 20(2):128-129.
16.	邓进巍, 张卫华, 刘燕. 腹腔镜在外科急腹症中的应用价值. 腹腔镜外科杂志, 2010, 15(6):447-449.
17.	李国库, 张云. 腹腔镜技术在急腹症中的应用. 中国现代药物应用, 2010, 4(12):89-90.
18.	Pezzolla A, Milella M, Lattarulo S, et al. Laparoscopic appendectomy.Our experience. Ann Ital Chir, 2012, 83(3):253-257.
19.	Markar SR, Venkat-Raman V, Ho A, et al. Laparoscopic versus openappendicectomy in obese patients. Int J Surg, 2011, 9(6):451-455.
20.	Sahm M, Pross M, Lippert H. Acute appendicitis-changes in epidemiology, diagnosis and therapy. Zentralbl Chir, 2011, 136(1):18-24.
21.	张大明, 李建军. 腹腔镜手术治疗粘连性肠梗阻的手术技巧. 腹腔镜外科杂志, 2012, 17(1):48-49.
22.	秦立国, 毕英谦. 急性阑尾炎行腹腔镜手术及开腹手术60例临床分析. 中华全科医学, 2012, 10(9):1400-1401.
23.	肖志刚, 黄忠诚, 刘升锋, 等. 腹腔镜技术在普外科急腹症诊治中的应用. 中国内镜杂志, 2011, 17(6):653-654.
24.	胡毅, 高文彪, 杨旭, 等. 腹腔镜在非创伤性急腹症中的临床应用价值探讨. 中国实用医药, 2012, 7(20):12-13.
25.	Durai R, Razvi A, Uzkalnis A, et al. Duodenal ulcer perforation:a district hospital experience. Acta Chir Belg, 2011, 111(1):23-25.

1. Richardson WS, Stefanidis D, Chang L, et al. The role of diagnostic laparoscopy for acute abdominal conditions:an evidence-based review. Surg Endosc, 2009, 23(9):2073-2077.
2. 马云涛, 苏河, 王斌, 等. 腹腔镜技术在外科急腹症中的应用. 中国微创外科杂志, 2009, 15(7):599-602.
3. Hori Y; SAGES Guidelines Committee. Diagnostic laparoscopy guidelines:this guideline was prepared by the SAGES Guidelines Committee and reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), November 2007. Surg Endosc, 2008, 22(5):1353-1383.
4. 石美鑫. 实用外科学. 北京:人民卫生出版社, 2002:755, 921.
5. 杨昌毅, 陈志山, 洪黎清, 等. 腹腔镜技术在急腹症诊治中的应用. 中国实用医刊, 2014, 41(20): 40-41.
6. 戢运俊, 孙卫兵, 和梅亮, 等. 腹腔镜技术在急腹症1 035例诊治中的应用. 中国临床新医学, 2013, 6(7): 689-691.
7. 叶春. 腹腔镜阑尾切除术40例治疗体会. 中国普外基础与临床杂志, 2012, 19(5):521.
8. 刘长昆, 王建, 于世良, 等. 腹腔镜与开腹手术治疗老年急性阑尾炎患者的疗效对比分析. 中国普外基础与临床杂志, 2011, 18(7):766-768.
9. 胡斌, 邓剑, 赵叶平, 等. 腹腔镜技术在急腹症诊治中的应用体会. 中国普外基础与临床杂志, 2013, 20(1): 85-87.
10. 翟文裕. 腹腔镜技术在急性弥漫性腹膜炎治疗过程中的疗效观察. 新疆医学, 2013, 43(3):109-110.
11. 宋贤超. 腹腔镜在普外科急腹症治疗中的应用分析. 中国医药指南, 2012, 10(14):100-101.
12. 亓玉忠, 王国斌. 腹腔镜阑尾切除术700例分析. 腹腔镜外科杂志, 2008, 13(5):416-417.
13. 李伯琴. 腹腔镜上消化道溃疡穿孔修补手术护理配合. 现代医药卫生, 2009, 25(16):2528-2529.
14. 余育晖, 钱章选, 郭庆渠. 腹腔镜技术在非创伤性外科急腹症中治疗的体会. 浙江创伤外科, 2013, 18(5):686-687.
15. 马雪平, 赵国发, 崔猛胜. 老年人腹腔镜胆囊切除术创伤反应临床观察. 中华消化内镜杂志, 2003, 20(2):128-129.
16. 邓进巍, 张卫华, 刘燕. 腹腔镜在外科急腹症中的应用价值. 腹腔镜外科杂志, 2010, 15(6):447-449.
17. 李国库, 张云. 腹腔镜技术在急腹症中的应用. 中国现代药物应用, 2010, 4(12):89-90.
18. Pezzolla A, Milella M, Lattarulo S, et al. Laparoscopic appendectomy.Our experience. Ann Ital Chir, 2012, 83(3):253-257.
19. Markar SR, Venkat-Raman V, Ho A, et al. Laparoscopic versus openappendicectomy in obese patients. Int J Surg, 2011, 9(6):451-455.
20. Sahm M, Pross M, Lippert H. Acute appendicitis-changes in epidemiology, diagnosis and therapy. Zentralbl Chir, 2011, 136(1):18-24.
21. 张大明, 李建军. 腹腔镜手术治疗粘连性肠梗阻的手术技巧. 腹腔镜外科杂志, 2012, 17(1):48-49.
22. 秦立国, 毕英谦. 急性阑尾炎行腹腔镜手术及开腹手术60例临床分析. 中华全科医学, 2012, 10(9):1400-1401.
23. 肖志刚, 黄忠诚, 刘升锋, 等. 腹腔镜技术在普外科急腹症诊治中的应用. 中国内镜杂志, 2011, 17(6):653-654.
24. 胡毅, 高文彪, 杨旭, 等. 腹腔镜在非创伤性急腹症中的临床应用价值探讨. 中国实用医药, 2012, 7(20):12-13.
25. Durai R, Razvi A, Uzkalnis A, et al. Duodenal ulcer perforation:a district hospital experience. Acta Chir Belg, 2011, 111(1):23-25.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Laparoscopy in The Diagnosis and Treatment of Acute Abdomen

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